Are you Iron Deficient?

There are a lot of different things that can contribute to this. Poor sleep is obviously at the top of the list. Hypothyroidism often plays a role. So do vitamin D insufficiency, adrenal dysregulation, neurotransmitter imbalance, and dysregulated Circadian Rhythms.

It’s simple, too, and easy to fix, if you have access to good food. It’s iron deficiency.

Iron Deficiency

Iron is an incredibly important mineral in the body.

Iron is a part of many enzymes. Enzymes help the body digest foods and also help with many other important reactions. Iron also plays many crucial roles in cell functionality. This affects many systems in the body, from the muslces to the organs, and to the brain.

Iron deficiency can delay motor function in infants, can increase the risk of giving birth to small, pre-term babies, and can affect memory and other mental functions in adults.

Yet most importantly, iron is the key player in the formation of hemoglobin. Hemoglobin carries oxygen from the lungs to the rest of the body. Without sufficient iron, cells literally asphyxiate themselves. They don’t have enough energy to work. This is called iron-deficiency anemia.

Cells need two things to function: glucose, and oxygen. If they don’t get oxygen because the hemoglobin supply is low, they are in for a lot of trouble.

Symptoms of Iron-Deficiency Anemia

There are many symptoms of iron-deficiency anemia, though they are all related, and signal cellular distress and a lack of energy. They are:

-Fatigue

-Sluggishness

-Breathlessness

-Headache

-Dizziness and light headedness

-Irritability

-Unusually pale skin

-Unusually slow hair growth

-Hair loss

-Cravings for non-nutritive substances like dirt, sand, ice, flour, or starch (this becomes more common the more severe the anemia)

Iron deficiency-anemia and women

Iron deficiency is the most common deficiency in women. Worldwide it affects 1 in 7 women. 1 in 7!! That’s an extraordinarily high number. These numbers are skewed towards women with limited nutrition, particularly those who live in poverty and/or have limited access to animal sources. Nevertheless iron deficiency persists as a very real and robust problem in well-fed nations like the United States.

Why is iron deficiency so common in women?

Vegetarianism may have something to do with it. There are 140% more female vegetarians than males, and vegetarian diets are very low in iron. However, there are male vegetarians who are not anemic at the same rate as women.

The most important factor in iron-deficiency anemia is menstruation. The more blood you lose on a regular basis, the less iron you have in your body. Each day of bleeding depletes iron stores by approximately 1 mg.

This increases the female need for iron compared to males by 200%. Men need 8 mg of iron a day. Due to menstruation, the recommended dose for women is 18 mg. If pregnant, that number skyrockets up to 27.

Causes of iron-deficiency anemia

Many people think that since they are paleo and eat meat they are off the hook. This is not true! It is important to consume iron, yes, but there are causes of iron-deficiency anemia other than vegetarianism. They are:

–A history of being on a vegetarian or vegan diet, especially within the last twelve months

–Focusing on fish, eggs, or poultry for protein and ignoring red meat, which is higher in iron

–Getting insufficient iron-containing protein. You should eat at very minimum 50 grams of animal protein a day.

–Having a regular, and especially if heavy, menstrual cycle. (Having to change tampons / pads / cups a few times a day is “heavy”)

–Being pregnant, or having been pregnant.

–Slow, chronic blood loss within the body — such as from a peptic ulcer, a hernia, a colon polyp or colorectal cancer. Chronic aspirin use can cause gastrointestinal bleeding.

–Uterine fibroids, cysts, and other potential sources of internal bleeding in the female reproductive system.

–Under-eating, counting calories, restrictive eating. All of these things limit the amount of nutrients and iron your body gets!

Testing for iron-deficiency anemia

Anemia is complicated. There are many things that can contribute to it and cause it – iron deficiency is not the only one.

Therefore what you need to look for is both anemia as well as iron-deficiency.

So you can test for iron in the blood. That will be low.

Additionally, to indicate anemia, jemoglobin, hematocrit, and red blood cell count will also likely be on the low end. Ferritin, the form of iron that can be stored in the body, if low will indicate that there’s a low amount of iron in storage. You may not test low in each of those four indicators based on your own personal physiology and problem, but at least one of them will be deficient if anemia is a problem.

Finally, if anemic, blood cells will be small and variable in shape. Healthy red blood cells are uniform in shape and nice and robust.

Replenishing iron

Replenishing iron stores can take a long time – up to several months of regularly consuming iron-rich foods or supplementing. Of course I recomend the food path, but there are also some excellent supplements.

You may wish to consider taking these supplements if anemic. You may also want to do so if pregnant, even if there is sufficient iron in your diet. There really is such an incredible need for iron while pregnant.

This is my favorite iron supplement:

Proferrin’s Iron. It’s iron in the polypeptide form. It’s absorbable and usable by the body, unlike some other supplements which are metallic and less useful for the body.

As for food,the best sources of iron are all animal products, since they contain heme iron. Heme iron is more bioavailable to your body than iron found in plants, because it’s already in a form friendly to animal cells. Heme iron is in fact approximately 250% more effective than non heme iron. Meat, fish, shellfish, organ meats, and poultry are all excellent sources of heme iron.

Second to heme iron, you can also get iron from leafy greens and beans. If you do choose the vegetarian or vegetable-heavy path, make sure to consume lots of vitamin C with your greens. Non-heme iron absorption increases in the presence of vitamin C.

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I have always had mid cycle bleeding but in the last year, especially the last six months, it has gotten excessively bad. Just last week, I found out that I have an uterine fibroid that is very large. I thought about supplementing with iron but hadn’t really worried about it until the corner of my mouth started breaking out really bad. It’s called angular cheillitis and most of the “cures” for it were chapstick, using peroxide on it, and not touching it. Which means weeks of discomfort. I finally found a source that said they can be caused by being low in certain nutrients, especially iron. I start supplementing with iron and within 3 days, it’s half the size. Sure it could be coincidence but I thought that would be a great tidbit for someone who wasn’t sure if they could be low on iron because I definitely hadn’t realized it.

P.S. I probably should have thought about being iron deficient but my previous OB told me the bleeding was pretty normal since it was around mid cycle. It wasn’t until after a year of trying to get pregnant that they started doing tests and found the fibroid. Hopefully, it will also help with my lack of energy too.

Story of my life. Heavy menstruation is my cause. I have adenomyosis so it’s not curable without a hysterectomy and I want babies. I also have low Wbc, do you think that is unrelated? Have you ever seen it with anemia

Hello Stefani,
within the course of half a year of paleo I was able to boost my ferritine from 50 to 75 🙂 and I aim to get it even higher. So I reduced poulty and increased red meat (lamb and beef). Chicken hearts and liver from various animals we eat at least once a week.

I’ve been chronically iron-deficient for as long as I remember. It’s just something I have to stay on top of, all the time, because if I go a few days or a week without eating red meat my levels drop enough for me to feel it. I gave up trying to donate blood several years ago because I got tired of them telling me “If you’d eaten a massive steak for breakfast, you’d probably be able to donate.”
I tried vegetarianism for a while as a teenager, and it was a complete disaster. Other people may be able to eat that way, but I’ve learned that I need meat.
I don’t think we ever identified a specific cause — I remember being prescribed iron supplements as young as 3 or 4. (I remember because they were liquid, and they tasted TERRIBLE.) The closest we could ever figure was that I have some kind of absorption problem. So I take my multivitamins 5 days a week, and I make sure I get at least 1 large serving of red meat every 2 days. There have been times where I’ve been distracted and oblivious, and had to find an emergency hamburger for lunch. The hamburger usually helps.

Thank you for this very timely post! My ferritin has been dropping steadily over time and is finally down to 14, which confirms iron deficiency. Lots of things to blame – heavy periods, Hashimoto’s, leaky gut. The worse thing is that feeling unwell makes it hard to be motivated to make positive changes in food choices, sleep, etc. In any case, I really appreciate the supplement recommendation and heme food guidelines 🙂

The real reason so many women are deficient is not menstruation, but the simple fact that our livers are smaller than men’s. The blood that is lost was already not supplying you with iron and it’s too little anyway.

The best tip I have to at least prevent anemia is to never eat dairy or other high calcium foods together with iron rich foods like beef. Calcium greatly reduces the uptake of iron. It won’t be a problem for paleo folk, but they’re not the only ones frequenting your blog 🙂 For the rest of us: no, don’t put cheese on your burger.